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Retraining
the Bowel
 It
is possible to retrain your bowel with a few changes in diet and lifestyle.
The four changes proposed below are aimed at producing regular bowel movements.
Within a few weeks of beginning a bowel retraining method, most people
can achieve regular bowel movements.
1) Diet
and Fluid Intake
Start bowel retraining by increasing Dietary
Fiber intake and increasing fluid intake. Eat whole grains, fresh
vegetables, fruits, and legumes and drink at least 3 liters of fluids
each day. Fluids and Dietary Fiber
will help you to produce good quality Stools
that are soft and easy to pass. About
The Importance of Fluids.
 2)
Exercise
Strong
intestinal and abdominal muscles will help to produce well formed stools
regularly. You can tone your Intestinal
and Abdominal Muscles, with just 5 minutes of daily exercise such
as walking, stair climbing and sit ups. If confined to bed, physical therapy
in the form of knee bends and leg lifts will help to tone these muscles.
To help you to recover control over your bowel movements
(especially if you have fecal incontinence) you can perform Kegel exercises.
The exercises consist of repeatedly contracting the sphincter muscles,
the perineal muscles and the buttocks at intervals of 3 sets of 15 repetitions
four times a day.
About
The Defecation Reflex
Whenever the Defecation
Reflex is stimulated, respond to it promptly. When the
reflex is ignored, stool is retained. Stool retained in the
colon can stretch out the rectal sack. When the rectal sack
is stretched out, more and more stool is required to fill
the sack before the reflex will be activated. Constipation
results as the stool that is retained in the colon becomes
dried out, hard and difficult to pass. The defecation
reflex can be anticipated as it usually triggered about 45
minutes to one hour upon rising from bed, after drinking a
hot beverage, or after eating a meal. Responding to the defecation
reflex helps to prevent it from breaking down. Once triggered,
the defecation reflex will last for about 15 minutes before
it disengages from being ignored. Like
any other muscle that is not used, it can breakdown and fail
to function.
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 3)
Train the Defecation Reflex
About one hour after eating, make time to relax on the toilet for about
15 minutes. If possible, try to perform this procedure
at the same time everyday. Consistency is
crucial for bowel retraining success. Without straining, allow
your body to eliminate urine, to pass gas, to pass stool or to do “nothing”.
Alternate a few minutes sitting upright on the toilet with a few minutes
bending forward while periodically and gently bearing down. This can increase
abdominal pressure and help to evacuate the bowel. Try to contract the
abdominal muscles and gently bear down when
stool is actually being expelled. Avoid bearing
down hard as this can cause pouches, called diverticuli, to form along
the colon. These pouches can create scars, catch particles of stool, become
infected and cause bleeding. This is a serious condition called diverticulosis.
Reading on the toilet can help some individuals to relax and produce a
bowel movement. However, sitting on the toilet for longer than 15 minutes
with no bowel activity, does not seem to advance bowel retraining and
is better if avoided. If nothing happens after 15 minutes, try again in
another hour or so. Bowel retraining requires patience.
Methods
for Encouraging Activity in the Bowels
Pressure: Bowel movements can
be encouraged by applying gentle pressure upward against the rectum.
You can do this by placing the palm of your hand against your rectum
and pressing upward. It is easiest to do this by sitting down over
the palm of your hand. Relax in this position for about 3-5 mintes.
You may be able to feel a gentle pressure begin to build in the colon.
After a few minutes, you should feel the muscles of your bowels begin
to move. If you do not have a bowel movement in about 20 minutes,
repeat this procedure again.
Digital Stimulation: You can also
encourage bowel movements by gently stimulating the rectum with your
finger. Gently insert a lubricated finger into the anus. Using a circular
motion, stimulate the rectal sack until the sphincter muscle relaxes.
This may take one or two minutes. If this does not produce movement
of the bowel in about 20 minutes, you can repeat this procedure again.
Abdominal Massage: You can also
stimulate movement in the bowels by gently massaging the abdominal
muscles in a circular motion across your abdomen. While applying gentle
pressure slowly move the palm of your hand from the lower right of
your abdomen up and across to the left side of your abdomen, down
and then back across to the right side of your abdomen again. Repeat
this motion for about one minute while sitting up on the toilet. Abdominal
massage can also be accomplished by lying on your back with your knees
tucked to your chest. Wrap your arms over your knees clasping opposite
elbows in your hands. Relax while holding this position for 2-3 minutes.
You can enhance this internal massage by gently rocking side to side
while holding this position. To recover, stretch out your legs and
rest for a minute or so. Repeat. It may be necessary
to perform one of these forms of stimulation everyday until a regular
pattern of bowel movements is established. |
4) Create
a Comfortable Environment
Create an environment in your bathroom that will help you to relax. Lighting
and extinguishing a candle while using the toilet can make the environment
pleasant for you and anyone who may need to use the toilet after you.
A supply of pre-moistened towelettes (or baby wipes) on the back of the
toilet can help you and everyone else in the family with personal hygiene.
Additionally, some interesting reading material or a battery operated
radio may to help pass the time.
For some
individuals, public restrooms are an undesirable environment, especially
when it comes to moving the bowels. When working on retraining your bowels,
responding to the reflex whenever it occurs is especially important even
if it means using a public restroom. If you are embarrassed about odor,
carry a small matchbook in your pocket. The smoke from a single match
will diffuse odors instantly and the cardboard stem can be flushed. Additionally,
carrying pre-moistened towelette can be a great help if toilet paper is
missing.
If
you have fecal incontinence,
wear clothes that are easily removed when it is time to move the bowels.
Make sure that your work, living and sleeping quarters are close to the
bathroom. Have furnishings arranged so that access to the toilet is not
hindered and have handrails installed to help provide support. If mobility
is limited, arrange a beside commode or a chamber pot for convenience.
Underline the bed sheet with a plastic bed sheet to help prevent soiling
the mattress. Use incontinence pads if necessary. With incontinence, it
is important to keep your bottom cleaned and moisturized. Practice the
Kegel exercises several times a day. Be patient, fecal incontinence can
be reversed in most cases.
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